Cascone Piero, Basile Emanuela, Saccucci Matteo, Di Carlo Gabriele, Angeletti Diletta, Ramieri Valerio, Polimeni Antonella
*Department of Odontostomatologic and Maxillo Facial Sciences, "Sapienza" University of Rome, Rome, Italy.
J Craniofac Surg. 2015 Nov;26(8):2325-8. doi: 10.1097/SCS.0000000000001997.
Pierre Robin Sequence is a congenital pathology defined by the triad micrognathia, glossoptosis and often a U-shaped cleft of soft palate. Newborns affected by airways obstruction may necessitate more invasive options: tongue-lip adhesion, tracheostomy and mandibular distraction osteogenesis. The authors analyzed the effect of fast and early mandibular osteodistraction on deciduous dental development in patients affected by Pierre Robin Sequence. Analysis of the patients treated for severe form was performed by a team composed by maxillofacial surgeons and dentists. Five patients were included for the analysis: before and long term clinical and radiological assessments were considered. All patients underwent fast and early mandibular osteodistraction; two years follow up computed tomography and panorex reconstructions showed bone consolidation, 33 of 35 teeth analyzed before ostedistraction are present after distraction protocol; no positional changes were detected at the follow up analysis either deciduous teeth and molar permanent buds. No deformities regarding molar buds were detected. In conclusion external mandibular distractor devices have been associated with dental injuries and facial scaring. Even though, the dental complications identified can not be unambiguously connected to the external distractor devices.
皮埃尔·罗宾序列征是一种先天性疾病,其特征为小颌畸形、舌后坠,且常伴有软腭U形腭裂。受气道阻塞影响的新生儿可能需要更具侵入性的治疗方法:舌唇粘连术、气管切开术和下颌骨牵张成骨术。作者分析了快速早期下颌骨牵张对皮埃尔·罗宾序列征患者乳牙发育的影响。由颌面外科医生和牙医组成的团队对接受严重形式治疗的患者进行了分析。纳入5例患者进行分析:考虑了治疗前及长期的临床和影像学评估。所有患者均接受了快速早期下颌骨牵张;两年的随访计算机断层扫描和曲面断层重建显示骨愈合,牵张方案实施后,35颗在牵张前分析的牙齿中有33颗仍然存在;随访分析未发现乳牙和恒牙牙胚有位置变化。未发现磨牙牙胚有畸形。总之,外置下颌骨牵张器与牙齿损伤和面部瘢痕有关。尽管如此,所确定的牙齿并发症并不能明确与外置牵张器相关。